Accuracy of Noninvasive Coronary Stenosis Quantification of Different Commercially Available Dedicated Software Packages

Riksta Dikkers, MD, Tineke P. Willems, PhD, MD, Gonda J. de Jonge, MD, Henk A. Marquering, PhD, Marcel J. W. Greuter, PhD, Peter M. A. van Ooijen, PhD, Marijke C. Jansen van der Weide, PhD, and Matthijs Oudkerk, MD, PhD

Purpose: The purpose of this study was to investigate the noninva�sive quantification of coronary artery stenosis using cardiac software packages and vessel phantoms with known stenosis severity.

Materials and Methods: Four different sizes of vessel phantoms were filled with contrast agent and scanned on a 64-slice multidetector computed tomography. Diameter and area stenosis were evaluated by 2 observers blinded from the true measures using 5 different software packages. Measurements were compared with the true measure of the vessel phantoms. The absolute difference in stenosis measure�ments and intraobserver and interobserver variabilities were assessed.

Results: All software packages show a trend toward larger differences for the smaller vessel phantoms. The absolute difference of the automatic measurements was significantly higher compared with that of the manual measurements in all 5 evaluated software packages for all vessel phantoms (P

Conclusion: Manual stenosis measurements are significantly more accurate compared with automatic measurements, and therefore, manual adjustments are still essential for noninvasive assessment of coronary artery stenosis.